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目的分析局部晚期宫颈癌新辅助化疗的临床疗效和卫生经济学指标,评价新辅助化疗的临床应用价值及可推广性。方法对2013年6月至2015年6月在首都医科大学附属北京妇产医院初次治疗的113例局部晚期宫颈癌患者进行回顾分析,根据手术前有无新辅助化疗分为新辅助化疗组(NACT组)和直接手术组,比较2组患者术中出血量、手术时间、术后复发、术后辅助治疗及治疗费用。结果随访发现2组患者复发率差异无统计学意义,新辅助化疗在宫颈癌治疗方面,可以减少术中出血、缩短手术时间、减少淋巴转移及脉管癌栓,部分避免了辅助放化疗、减少了术后治疗费用,但治疗总费用高于直接手术组,差异有统计学意义。结论虽然直接手术组有较好的卫生经济效益,但新辅助化疗临床疗效好,为部分患者创造了手术条件,值得推广使用。
Objective To analyze the clinical efficacy and health economics of neoadjuvant chemotherapy for locally advanced cervical cancer and evaluate the clinical value and feasibility of neoadjuvant chemotherapy. Methods A retrospective analysis was performed on 113 patients with locally advanced cervical cancer who were initially treated in Beijing Maternity Hospital affiliated to Capital Medical University from June 2013 to June 2015. According to the presence or absence of neoadjuvant chemotherapy before surgery, the patients were divided into two groups: neoadjuvant chemotherapy group (NACT Group) and direct surgery group. The blood loss, operation time, recurrence, postoperative adjuvant therapy and treatment cost were compared between two groups. Results The follow-up found no significant difference in the recurrence rate between the two groups. Neoadjuvant chemotherapy can reduce the intraoperative bleeding, shorten the operation time, reduce the lymphatic metastasis and vascular thrombosis, partly avoid the adjuvant chemoradiotherapy and reduce The postoperative treatment costs, but the total cost of treatment was higher than direct surgery group, the difference was statistically significant. Conclusion Although direct surgery group has good health and economic benefits, neoadjuvant chemotherapy has good clinical curative effect and has created operating conditions for some patients and is worth promoting.